How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $602.56 | Facility | None | $213.80 | $223.87 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $338.84 | Professional | None | $208.93 | $213.80 | $338.84 |
BCBS Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $851.14 | Facility | None | $218.78 | $436.52 | $851.14 |
BCBS Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | None | $154.88 | $162.18 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | None | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $616.60 | Facility | None | $194.98 | $269.15 | $616.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $295.12 | Professional | None | $194.98 | $218.78 | $295.12 |
Priority Health Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | None | $208.93 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $275.42 | Professional | None | $186.21 | $208.93 | $275.42 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $107.15 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $33.88 |
BCBS Setting Professional Modifier JW · Drug discarded Typical Low $144.54 Median $154.88 Typical High $162.18 | Professional | JW · Drug discarded | $144.54 | $154.88 | $162.18 |
Where Michigan sits
The same service costs 28.2 times more in Alabama than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 25th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.